The Importance of Medical Records and Mental Health Records in Establishing Social Security Disability Insurance and Supplemental Security Income Claims

Now that the government has reopened and all branches of the Social Security Administration (“SSA”) are back in full swing, Cari and I wanted to discuss the importance of documenting your disability for Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) purposes.  The bottom-line is that if the objective medical findings and clinical findings are not detailed and strong, it will be difficult to achieve SSDI/SSI benefits.

 

While SSA must consider an individual’s subjective complaints and credibility when assessing a claim, if an individual is not in consistent medical treatment with the appropriate medical provider, SSA will deny the claim. Think of it this way – the objective findings trump an individual’s subject complaints.

 

 SSA also has certain rules in terms of evidence it will consider. SSA only gives controlling weight to the opinions of certain medical providers. These acceptable medical providers include:  M.D.s, D.O.s, Ph.D.s, and Psy.D.s. SSA will not give controlling weight to the opinions of chiropractors, acupuncturists, nurses, physician assistants, social workers, or therapists. Thus, if you are not treating with the appropriate medical provider, you will want to get into treatment with a medical source that SSA deems “acceptable.”

 

You also want to make sure you are treating with the correct specialist for the impairment you are alleging. If you are claiming a psychiatric disability, you should be treating and receiving your medications from an actual psychiatrist, not a general practitioner, or an internist.

 

You also want to make sure your doctor is documenting all that you tell him/her in a clear and concise manner in the medical records. After all, if SSA cannot understand or read a doctor’s chart, it will be difficult for SSA to find an individual disabled.

 

Securing a narrative letter or a residual functioning capacity statement from your doctor can also be crucial. These documents in which a doctor lays out an individual’s impairments, symptoms, treatment, prognosis, and limitations can help SSA understand in a very simple summary why a claimant is unable to work. SSA will often have their paid consultative examiners complete these same reports. Since SSA is supposed to give more weight to the opinion of a treating doctor, than that of the opinion of their one-time consultative evaluators, the ability to secure opinion evidence from a treating provider will often make or break the claim.

 

Finally, if an individual does not have medical insurance and is not currently treating with a doctor, the chances of being awarded SSA benefits is slim to none. If you fall into this category, we recommend that you seek out treatment through County plans and facilities, or low-cost and free neighborhood clinics. Under the Federal government’s Health Care Reform, individuals who do not secure health insurance will soon be subject to financial penalties. Thus, we also recommend that you checkout the new exchanges set up by the Federal government to determine if you are eligible for any of their low-cost plans.

 

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

How The Government Shutdown is Affecting the Social Security Administration

As you all are aware, the government shut down on October 1, 2013, due to Congress’ inability to come to a resolution on an appropriations bill. An agreement has not yet been reached.  What this means is that non-excepted government employees (approximately 800,000) have been furloughed and certain Federal agencies are operating with only staff members who are deemed essential.

The good news is that part of the Social Security Administration remains operational. Social Security Disability Insurance and Supplemental Security Income (“SSDI/SSI”) beneficiaries will continue to receive checks. Individuals can still apply for SSDI/SSI benefits. SSDI/SSI claims can still be appealed. Most other work at the local SSA offices will be suspended. This includes requesting a duplicate Social Security card.

Hearings that were previously scheduled at the Office of Disability Adjudication and Review (“ODAR”) will still take place if the Judge’s clerk was able to prepare the hearing file before the shutdown occurred. No other hearings will be scheduled, however, and no decisions or other correspondences will be written. The ODAR will be operating with a skeletal staff.

The Appeals Council will not be reviewing any cases at all.

For more informational on the government shutdown and how it affects SSA, please visit:

 http://www.ssa.gov/pressoffice/shutdown2013.pdf

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.